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Paver/Brick Order Form

Paver/Brick Order Form

Paver/Brick Order Form

 

 Proceeds benefit the St. Joseph Church Men's Club. (Social group that also raises funds for church use.)

 

 (Buy one brick and the second one is 1/2 price!)

 

 

 

Purchaser's Name _________________________ ___________________

Phone Number  _________________________ _____________

 

Engraving (20 characters per line):

 

_______ 4" x 8" paver with three lines for $200.00

 

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_______  8" x 8" paver witih six lines for $350.00

 

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I have reviewed the above and it meets with my approval:

 

_________________________ _________________________ ______ 

Date

 

___________________

Signature

 

Amount Paid with Order: $ _________________

Balance Due:  $ ____________

 


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